SEIU LOCAL 200UNITED BENEFIT FUND has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan SEIU LOCAL 200UNITED BENEFIT FUND
| Measure | Date | Value |
|---|
| 2022 : SEIU LOCAL 200UNITED BENEFIT FUND 2022 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2022-12-31 | $-253,848 |
| Total unrealized appreciation/depreciation of assets | 2022-12-31 | $-253,848 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-12-31 | $54,694 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2022-12-31 | $51,935 |
| Total income from all sources (including contributions) | 2022-12-31 | $495,685 |
| Total loss/gain on sale of assets | 2022-12-31 | $5,640 |
| Total of all expenses incurred | 2022-12-31 | $836,110 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2022-12-31 | $639,795 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2022-12-31 | $789,567 |
| Value of total assets at end of year | 2022-12-31 | $1,871,152 |
| Value of total assets at beginning of year | 2022-12-31 | $2,208,818 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2022-12-31 | $196,315 |
| Total interest from all sources | 2022-12-31 | $15,745 |
| Total dividends received (eg from common stock, registered investment company shares) | 2022-12-31 | $24,717 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2022-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2022-12-31 | $17,308 |
| Administrative expenses professional fees incurred | 2022-12-31 | $31,012 |
| Was this plan covered by a fidelity bond | 2022-12-31 | Yes |
| Value of fidelity bond cover | 2022-12-31 | $300,000 |
| If this is an individual account plan, was there a blackout period | 2022-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2022-12-31 | No |
| Contributions received from participants | 2022-12-31 | $80,876 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2022-12-31 | $3,308 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2022-12-31 | $6,588 |
| Other income not declared elsewhere | 2022-12-31 | $96 |
| Administrative expenses (other) incurred | 2022-12-31 | $149,343 |
| Liabilities. Value of operating payables at end of year | 2022-12-31 | $4,104 |
| Liabilities. Value of operating payables at beginning of year | 2022-12-31 | $3,524 |
| Total non interest bearing cash at end of year | 2022-12-31 | $62,905 |
| Total non interest bearing cash at beginning of year | 2022-12-31 | $54,180 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-12-31 | No |
| Value of net income/loss | 2022-12-31 | $-340,425 |
| Value of net assets at end of year (total assets less liabilities) | 2022-12-31 | $1,816,458 |
| Value of net assets at beginning of year (total assets less liabilities) | 2022-12-31 | $2,156,883 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2022-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2022-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2022-12-31 | No |
| Investment advisory and management fees | 2022-12-31 | $15,960 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2022-12-31 | $579,128 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2022-12-31 | $466,667 |
| Income. Interest from US Government securities | 2022-12-31 | $15,613 |
| Income. Interest from corporate debt instruments | 2022-12-31 | $132 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2022-12-31 | $75,988 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2022-12-31 | $39,833 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2022-12-31 | $39,833 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2022-12-31 | $217,331 |
| Asset value of US Government securities at end of year | 2022-12-31 | $608,570 |
| Asset value of US Government securities at beginning of year | 2022-12-31 | $785,269 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2022-12-31 | $-86,232 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2022-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2022-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2022-12-31 | No |
| Contributions received in cash from employer | 2022-12-31 | $708,691 |
| Employer contributions (assets) at end of year | 2022-12-31 | $16,557 |
| Employer contributions (assets) at beginning of year | 2022-12-31 | $51,099 |
| Income. Dividends from common stock | 2022-12-31 | $7,409 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2022-12-31 | $422,464 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2022-12-31 | $15,096 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2022-12-31 | No |
| Assets. Corporate common stocks other than exployer securities at end of year | 2022-12-31 | $524,299 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2022-12-31 | $788,487 |
| Liabilities. Value of benefit claims payable at end of year | 2022-12-31 | $50,590 |
| Liabilities. Value of benefit claims payable at beginning of year | 2022-12-31 | $48,411 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2022-12-31 | $397 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2022-12-31 | $1,599 |
| Did the plan have assets held for investment | 2022-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2022-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2022-12-31 | No |
| Aggregate proceeds on sale of assets | 2022-12-31 | $1,481,223 |
| Aggregate carrying amount (costs) on sale of assets | 2022-12-31 | $1,475,583 |
| Opinion of an independent qualified public accountant for this plan | 2022-12-31 | Unqualified |
| Accountancy firm name | 2022-12-31 | BONADIO & CO., LLP |
| Accountancy firm EIN | 2022-12-31 | 161131146 |
| 2021 : SEIU LOCAL 200UNITED BENEFIT FUND 2021 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2021-12-31 | $-7,494 |
| Total unrealized appreciation/depreciation of assets | 2021-12-31 | $-7,494 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-12-31 | $51,935 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2021-12-31 | $50,087 |
| Total income from all sources (including contributions) | 2021-12-31 | $1,001,974 |
| Total loss/gain on sale of assets | 2021-12-31 | $125,740 |
| Total of all expenses incurred | 2021-12-31 | $891,500 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2021-12-31 | $675,607 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2021-12-31 | $808,733 |
| Value of total assets at end of year | 2021-12-31 | $2,208,818 |
| Value of total assets at beginning of year | 2021-12-31 | $2,096,496 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2021-12-31 | $215,893 |
| Total interest from all sources | 2021-12-31 | $15,490 |
| Total dividends received (eg from common stock, registered investment company shares) | 2021-12-31 | $19,626 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2021-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2021-12-31 | $11,180 |
| Administrative expenses professional fees incurred | 2021-12-31 | $54,193 |
| Was this plan covered by a fidelity bond | 2021-12-31 | Yes |
| Value of fidelity bond cover | 2021-12-31 | $300,000 |
| If this is an individual account plan, was there a blackout period | 2021-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2021-12-31 | No |
| Contributions received from participants | 2021-12-31 | $99,600 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2021-12-31 | $6,588 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2021-12-31 | $5,043 |
| Other income not declared elsewhere | 2021-12-31 | $16,362 |
| Administrative expenses (other) incurred | 2021-12-31 | $145,160 |
| Liabilities. Value of operating payables at end of year | 2021-12-31 | $3,524 |
| Liabilities. Value of operating payables at beginning of year | 2021-12-31 | $5,995 |
| Total non interest bearing cash at end of year | 2021-12-31 | $54,180 |
| Total non interest bearing cash at beginning of year | 2021-12-31 | $108,874 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-12-31 | No |
| Value of net income/loss | 2021-12-31 | $110,474 |
| Value of net assets at end of year (total assets less liabilities) | 2021-12-31 | $2,156,883 |
| Value of net assets at beginning of year (total assets less liabilities) | 2021-12-31 | $2,046,409 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2021-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2021-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2021-12-31 | No |
| Investment advisory and management fees | 2021-12-31 | $16,540 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2021-12-31 | $466,667 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2021-12-31 | $442,507 |
| Income. Interest from US Government securities | 2021-12-31 | $15,074 |
| Income. Interest from corporate debt instruments | 2021-12-31 | $416 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2021-12-31 | $39,833 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2021-12-31 | $38,631 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2021-12-31 | $38,631 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2021-12-31 | $229,375 |
| Asset value of US Government securities at end of year | 2021-12-31 | $785,269 |
| Asset value of US Government securities at beginning of year | 2021-12-31 | $678,309 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2021-12-31 | $23,517 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2021-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2021-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2021-12-31 | No |
| Contributions received in cash from employer | 2021-12-31 | $709,133 |
| Employer contributions (assets) at end of year | 2021-12-31 | $51,099 |
| Employer contributions (assets) at beginning of year | 2021-12-31 | $43,818 |
| Income. Dividends from common stock | 2021-12-31 | $8,446 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2021-12-31 | $446,232 |
| Asset. Corporate debt instrument debt (other) at end of year | 2021-12-31 | $15,096 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2021-12-31 | $15,485 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2021-12-31 | No |
| Assets. Corporate common stocks other than exployer securities at end of year | 2021-12-31 | $788,487 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2021-12-31 | $760,721 |
| Liabilities. Value of benefit claims payable at end of year | 2021-12-31 | $48,411 |
| Liabilities. Value of benefit claims payable at beginning of year | 2021-12-31 | $44,092 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2021-12-31 | $1,599 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2021-12-31 | $3,108 |
| Did the plan have assets held for investment | 2021-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2021-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2021-12-31 | No |
| Aggregate proceeds on sale of assets | 2021-12-31 | $856,739 |
| Aggregate carrying amount (costs) on sale of assets | 2021-12-31 | $730,999 |
| Opinion of an independent qualified public accountant for this plan | 2021-12-31 | Unqualified |
| Accountancy firm name | 2021-12-31 | BONADIO & CO., LLP |
| Accountancy firm EIN | 2021-12-31 | 161131146 |
| 2020 : SEIU LOCAL 200UNITED BENEFIT FUND 2020 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2020-12-31 | $70,747 |
| Total unrealized appreciation/depreciation of assets | 2020-12-31 | $70,747 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-12-31 | $50,087 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2020-12-31 | $45,871 |
| Total income from all sources (including contributions) | 2020-12-31 | $1,182,821 |
| Total loss/gain on sale of assets | 2020-12-31 | $150,991 |
| Total of all expenses incurred | 2020-12-31 | $878,272 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2020-12-31 | $590,156 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2020-12-31 | $809,117 |
| Value of total assets at end of year | 2020-12-31 | $2,096,496 |
| Value of total assets at beginning of year | 2020-12-31 | $1,787,731 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2020-12-31 | $288,116 |
| Total interest from all sources | 2020-12-31 | $13,934 |
| Total dividends received (eg from common stock, registered investment company shares) | 2020-12-31 | $17,725 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2020-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2020-12-31 | $7,663 |
| Administrative expenses professional fees incurred | 2020-12-31 | $40,577 |
| Was this plan covered by a fidelity bond | 2020-12-31 | Yes |
| Value of fidelity bond cover | 2020-12-31 | $300,000 |
| If this is an individual account plan, was there a blackout period | 2020-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2020-12-31 | No |
| Contributions received from participants | 2020-12-31 | $85,608 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2020-12-31 | $5,043 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2020-12-31 | $8,145 |
| Other income not declared elsewhere | 2020-12-31 | $79,135 |
| Administrative expenses (other) incurred | 2020-12-31 | $233,066 |
| Liabilities. Value of operating payables at end of year | 2020-12-31 | $5,995 |
| Liabilities. Value of operating payables at beginning of year | 2020-12-31 | $6,678 |
| Total non interest bearing cash at end of year | 2020-12-31 | $108,874 |
| Total non interest bearing cash at beginning of year | 2020-12-31 | $14,134 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-12-31 | No |
| Value of net income/loss | 2020-12-31 | $304,549 |
| Value of net assets at end of year (total assets less liabilities) | 2020-12-31 | $2,046,409 |
| Value of net assets at beginning of year (total assets less liabilities) | 2020-12-31 | $1,741,860 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2020-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2020-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2020-12-31 | No |
| Investment advisory and management fees | 2020-12-31 | $14,473 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2020-12-31 | $442,507 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2020-12-31 | $400,446 |
| Income. Interest from US Government securities | 2020-12-31 | $13,495 |
| Income. Interest from corporate debt instruments | 2020-12-31 | $439 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2020-12-31 | $38,631 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2020-12-31 | $26,486 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2020-12-31 | $26,486 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2020-12-31 | $226,142 |
| Asset value of US Government securities at end of year | 2020-12-31 | $678,309 |
| Asset value of US Government securities at beginning of year | 2020-12-31 | $631,732 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2020-12-31 | $41,172 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2020-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2020-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2020-12-31 | No |
| Contributions received in cash from employer | 2020-12-31 | $723,509 |
| Employer contributions (assets) at end of year | 2020-12-31 | $43,818 |
| Employer contributions (assets) at beginning of year | 2020-12-31 | $54,743 |
| Income. Dividends from common stock | 2020-12-31 | $10,062 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2020-12-31 | $364,014 |
| Asset. Corporate debt instrument debt (other) at end of year | 2020-12-31 | $15,485 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2020-12-31 | $30,398 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2020-12-31 | No |
| Assets. Corporate common stocks other than exployer securities at end of year | 2020-12-31 | $760,721 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2020-12-31 | $616,782 |
| Liabilities. Value of benefit claims payable at end of year | 2020-12-31 | $44,092 |
| Liabilities. Value of benefit claims payable at beginning of year | 2020-12-31 | $39,193 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2020-12-31 | $3,108 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2020-12-31 | $4,865 |
| Did the plan have assets held for investment | 2020-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2020-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2020-12-31 | No |
| Aggregate proceeds on sale of assets | 2020-12-31 | $1,987,711 |
| Aggregate carrying amount (costs) on sale of assets | 2020-12-31 | $1,836,720 |
| Opinion of an independent qualified public accountant for this plan | 2020-12-31 | Unqualified |
| Accountancy firm name | 2020-12-31 | BONADIO & CO., LLP |
| Accountancy firm EIN | 2020-12-31 | 161131146 |
| 2019 : SEIU LOCAL 200UNITED BENEFIT FUND 2019 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2019-12-31 | $8,105 |
| Total unrealized appreciation/depreciation of assets | 2019-12-31 | $8,105 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-12-31 | $45,871 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2019-12-31 | $31,704 |
| Total income from all sources (including contributions) | 2019-12-31 | $744,525 |
| Total loss/gain on sale of assets | 2019-12-31 | $116,099 |
| Total of all expenses incurred | 2019-12-31 | $658,474 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2019-12-31 | $387,344 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2019-12-31 | $469,315 |
| Value of total assets at end of year | 2019-12-31 | $1,787,731 |
| Value of total assets at beginning of year | 2019-12-31 | $1,687,513 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2019-12-31 | $271,130 |
| Total interest from all sources | 2019-12-31 | $19,973 |
| Total dividends received (eg from common stock, registered investment company shares) | 2019-12-31 | $17,134 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2019-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2019-12-31 | $8,910 |
| Administrative expenses professional fees incurred | 2019-12-31 | $77,993 |
| Was this plan covered by a fidelity bond | 2019-12-31 | Yes |
| Value of fidelity bond cover | 2019-12-31 | $300,000 |
| If this is an individual account plan, was there a blackout period | 2019-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2019-12-31 | No |
| Contributions received from participants | 2019-12-31 | $54,385 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2019-12-31 | $8,145 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2019-12-31 | $4,553 |
| Other income not declared elsewhere | 2019-12-31 | $16,135 |
| Administrative expenses (other) incurred | 2019-12-31 | $180,269 |
| Liabilities. Value of operating payables at end of year | 2019-12-31 | $6,678 |
| Liabilities. Value of operating payables at beginning of year | 2019-12-31 | $6,159 |
| Total non interest bearing cash at end of year | 2019-12-31 | $14,134 |
| Total non interest bearing cash at beginning of year | 2019-12-31 | $51,759 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | No |
| Value of net income/loss | 2019-12-31 | $86,051 |
| Value of net assets at end of year (total assets less liabilities) | 2019-12-31 | $1,741,860 |
| Value of net assets at beginning of year (total assets less liabilities) | 2019-12-31 | $1,655,809 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2019-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2019-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2019-12-31 | No |
| Investment advisory and management fees | 2019-12-31 | $12,868 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2019-12-31 | $400,446 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2019-12-31 | $355,715 |
| Interest earned on other investments | 2019-12-31 | $3,669 |
| Income. Interest from US Government securities | 2019-12-31 | $14,559 |
| Income. Interest from corporate debt instruments | 2019-12-31 | $1,745 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2019-12-31 | $26,486 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2019-12-31 | $43,072 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2019-12-31 | $43,072 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2019-12-31 | $0 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2019-12-31 | $169,769 |
| Asset value of US Government securities at end of year | 2019-12-31 | $631,732 |
| Asset value of US Government securities at beginning of year | 2019-12-31 | $651,178 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2019-12-31 | $97,764 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2019-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2019-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2019-12-31 | No |
| Contributions received in cash from employer | 2019-12-31 | $414,930 |
| Employer contributions (assets) at end of year | 2019-12-31 | $54,743 |
| Employer contributions (assets) at beginning of year | 2019-12-31 | $16,137 |
| Income. Dividends from common stock | 2019-12-31 | $8,224 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2019-12-31 | $217,575 |
| Asset. Corporate debt instrument debt (other) at end of year | 2019-12-31 | $30,398 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2019-12-31 | $75,410 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2019-12-31 | No |
| Assets. Corporate common stocks other than exployer securities at end of year | 2019-12-31 | $616,782 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2019-12-31 | $487,953 |
| Liabilities. Value of benefit claims payable at end of year | 2019-12-31 | $39,193 |
| Liabilities. Value of benefit claims payable at beginning of year | 2019-12-31 | $25,545 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2019-12-31 | $4,865 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2019-12-31 | $1,736 |
| Did the plan have assets held for investment | 2019-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2019-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2019-12-31 | No |
| Aggregate proceeds on sale of assets | 2019-12-31 | $895,381 |
| Aggregate carrying amount (costs) on sale of assets | 2019-12-31 | $779,282 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2019-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2019-12-31 | Unqualified |
| Accountancy firm name | 2019-12-31 | BONADIO & CO., LLP |
| Accountancy firm EIN | 2019-12-31 | 161131146 |
| 2018 : SEIU LOCAL 200UNITED BENEFIT FUND 2018 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2018-12-31 | $-102,101 |
| Total unrealized appreciation/depreciation of assets | 2018-12-31 | $-102,101 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-12-31 | $31,704 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2018-12-31 | $17,117 |
| Total income from all sources (including contributions) | 2018-12-31 | $347,645 |
| Total loss/gain on sale of assets | 2018-12-31 | $61,999 |
| Total of all expenses incurred | 2018-12-31 | $561,192 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2018-12-31 | $336,516 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2018-12-31 | $374,034 |
| Value of total assets at end of year | 2018-12-31 | $1,687,513 |
| Value of total assets at beginning of year | 2018-12-31 | $1,886,473 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2018-12-31 | $224,676 |
| Total interest from all sources | 2018-12-31 | $19,930 |
| Total dividends received (eg from common stock, registered investment company shares) | 2018-12-31 | $14,113 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2018-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2018-12-31 | $5,139 |
| Administrative expenses professional fees incurred | 2018-12-31 | $83,033 |
| Was this plan covered by a fidelity bond | 2018-12-31 | Yes |
| Value of fidelity bond cover | 2018-12-31 | $300,000 |
| If this is an individual account plan, was there a blackout period | 2018-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2018-12-31 | No |
| Contributions received from participants | 2018-12-31 | $31,098 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2018-12-31 | $4,553 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2018-12-31 | $8,197 |
| Other income not declared elsewhere | 2018-12-31 | $2,910 |
| Administrative expenses (other) incurred | 2018-12-31 | $129,756 |
| Liabilities. Value of operating payables at end of year | 2018-12-31 | $6,159 |
| Liabilities. Value of operating payables at beginning of year | 2018-12-31 | $8,117 |
| Total non interest bearing cash at end of year | 2018-12-31 | $51,759 |
| Total non interest bearing cash at beginning of year | 2018-12-31 | $44,033 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-12-31 | No |
| Value of net income/loss | 2018-12-31 | $-213,547 |
| Value of net assets at end of year (total assets less liabilities) | 2018-12-31 | $1,655,809 |
| Value of net assets at beginning of year (total assets less liabilities) | 2018-12-31 | $1,869,356 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2018-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2018-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2018-12-31 | No |
| Investment advisory and management fees | 2018-12-31 | $11,887 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2018-12-31 | $355,715 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2018-12-31 | $383,973 |
| Interest earned on other investments | 2018-12-31 | $512 |
| Income. Interest from US Government securities | 2018-12-31 | $15,971 |
| Income. Interest from corporate debt instruments | 2018-12-31 | $3,432 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2018-12-31 | $43,072 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2018-12-31 | $48,002 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2018-12-31 | $48,002 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2018-12-31 | $15 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2018-12-31 | $169,766 |
| Asset value of US Government securities at end of year | 2018-12-31 | $651,178 |
| Asset value of US Government securities at beginning of year | 2018-12-31 | $670,888 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2018-12-31 | $-23,240 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2018-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2018-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2018-12-31 | No |
| Contributions received in cash from employer | 2018-12-31 | $342,936 |
| Employer contributions (assets) at end of year | 2018-12-31 | $16,137 |
| Employer contributions (assets) at beginning of year | 2018-12-31 | $25,555 |
| Income. Dividends from common stock | 2018-12-31 | $8,974 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2018-12-31 | $166,750 |
| Asset. Corporate debt instrument debt (other) at end of year | 2018-12-31 | $75,410 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2018-12-31 | $98,223 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2018-12-31 | No |
| Assets. Corporate common stocks other than exployer securities at end of year | 2018-12-31 | $487,953 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2018-12-31 | $604,377 |
| Liabilities. Value of benefit claims payable at end of year | 2018-12-31 | $25,545 |
| Liabilities. Value of benefit claims payable at beginning of year | 2018-12-31 | $9,000 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2018-12-31 | $1,736 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2018-12-31 | $3,225 |
| Did the plan have assets held for investment | 2018-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2018-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2018-12-31 | No |
| Aggregate proceeds on sale of assets | 2018-12-31 | $467,825 |
| Aggregate carrying amount (costs) on sale of assets | 2018-12-31 | $405,826 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2018-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2018-12-31 | Unqualified |
| Accountancy firm name | 2018-12-31 | BONADIO & CO., LLP |
| Accountancy firm EIN | 2018-12-31 | 161131146 |
| 2017 : SEIU LOCAL 200UNITED BENEFIT FUND 2017 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2017-12-31 | $16,270 |
| Total unrealized appreciation/depreciation of assets | 2017-12-31 | $16,270 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-12-31 | $17,117 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2017-12-31 | $16,636 |
| Total income from all sources (including contributions) | 2017-12-31 | $552,341 |
| Total loss/gain on sale of assets | 2017-12-31 | $131,838 |
| Total of all expenses incurred | 2017-12-31 | $517,014 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2017-12-31 | $293,765 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2017-12-31 | $343,083 |
| Value of total assets at end of year | 2017-12-31 | $1,886,473 |
| Value of total assets at beginning of year | 2017-12-31 | $1,850,665 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2017-12-31 | $223,249 |
| Total interest from all sources | 2017-12-31 | $14,314 |
| Total dividends received (eg from common stock, registered investment company shares) | 2017-12-31 | $14,876 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2017-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2017-12-31 | $5,975 |
| Administrative expenses professional fees incurred | 2017-12-31 | $85,823 |
| Was this plan covered by a fidelity bond | 2017-12-31 | Yes |
| Value of fidelity bond cover | 2017-12-31 | $300,000 |
| If this is an individual account plan, was there a blackout period | 2017-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2017-12-31 | No |
| Contributions received from participants | 2017-12-31 | $26,141 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2017-12-31 | $8,197 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2017-12-31 | $4,503 |
| Other income not declared elsewhere | 2017-12-31 | $4,090 |
| Administrative expenses (other) incurred | 2017-12-31 | $125,333 |
| Liabilities. Value of operating payables at end of year | 2017-12-31 | $17,117 |
| Liabilities. Value of operating payables at beginning of year | 2017-12-31 | $16,636 |
| Total non interest bearing cash at end of year | 2017-12-31 | $44,033 |
| Total non interest bearing cash at beginning of year | 2017-12-31 | $19,000 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-12-31 | No |
| Value of net income/loss | 2017-12-31 | $35,327 |
| Value of net assets at end of year (total assets less liabilities) | 2017-12-31 | $1,869,356 |
| Value of net assets at beginning of year (total assets less liabilities) | 2017-12-31 | $1,834,029 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2017-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2017-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2017-12-31 | No |
| Investment advisory and management fees | 2017-12-31 | $12,093 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2017-12-31 | $383,973 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2017-12-31 | $424,803 |
| Income. Interest from US Government securities | 2017-12-31 | $7,926 |
| Income. Interest from corporate debt instruments | 2017-12-31 | $6,145 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2017-12-31 | $48,002 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2017-12-31 | $34,104 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2017-12-31 | $34,104 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2017-12-31 | $243 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2017-12-31 | $186,123 |
| Asset value of US Government securities at end of year | 2017-12-31 | $670,888 |
| Asset value of US Government securities at beginning of year | 2017-12-31 | $432,854 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2017-12-31 | $27,870 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2017-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2017-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2017-12-31 | No |
| Contributions received in cash from employer | 2017-12-31 | $316,942 |
| Employer contributions (assets) at end of year | 2017-12-31 | $25,555 |
| Employer contributions (assets) at beginning of year | 2017-12-31 | $15,163 |
| Income. Dividends from common stock | 2017-12-31 | $8,901 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2017-12-31 | $107,642 |
| Asset. Corporate debt instrument debt (other) at end of year | 2017-12-31 | $98,223 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2017-12-31 | $227,239 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2017-12-31 | No |
| Assets. Corporate common stocks other than exployer securities at end of year | 2017-12-31 | $604,377 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2017-12-31 | $692,999 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2017-12-31 | $3,225 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2017-12-31 | $0 |
| Did the plan have assets held for investment | 2017-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2017-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2017-12-31 | No |
| Aggregate proceeds on sale of assets | 2017-12-31 | $725,460 |
| Aggregate carrying amount (costs) on sale of assets | 2017-12-31 | $593,622 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2017-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2017-12-31 | Unqualified |
| Accountancy firm name | 2017-12-31 | BONADIO & CO., LLP |
| Accountancy firm EIN | 2017-12-31 | 161131146 |
| 2016 : SEIU LOCAL 200UNITED BENEFIT FUND 2016 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2016-12-31 | $-94,976 |
| Total unrealized appreciation/depreciation of assets | 2016-12-31 | $-94,976 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-12-31 | $16,636 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2016-12-31 | $23,515 |
| Total income from all sources (including contributions) | 2016-12-31 | $416,168 |
| Total loss/gain on sale of assets | 2016-12-31 | $125,056 |
| Total of all expenses incurred | 2016-12-31 | $556,755 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2016-12-31 | $318,863 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2016-12-31 | $344,533 |
| Value of total assets at end of year | 2016-12-31 | $1,850,665 |
| Value of total assets at beginning of year | 2016-12-31 | $1,998,131 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2016-12-31 | $237,892 |
| Total interest from all sources | 2016-12-31 | $15,223 |
| Total dividends received (eg from common stock, registered investment company shares) | 2016-12-31 | $14,859 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2016-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2016-12-31 | $5,930 |
| Administrative expenses professional fees incurred | 2016-12-31 | $107,369 |
| Was this plan covered by a fidelity bond | 2016-12-31 | Yes |
| Value of fidelity bond cover | 2016-12-31 | $300,000 |
| If this is an individual account plan, was there a blackout period | 2016-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2016-12-31 | No |
| Contributions received from participants | 2016-12-31 | $17,636 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2016-12-31 | $4,503 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2016-12-31 | $5,232 |
| Administrative expenses (other) incurred | 2016-12-31 | $118,136 |
| Liabilities. Value of operating payables at end of year | 2016-12-31 | $16,636 |
| Liabilities. Value of operating payables at beginning of year | 2016-12-31 | $23,515 |
| Total non interest bearing cash at end of year | 2016-12-31 | $19,000 |
| Total non interest bearing cash at beginning of year | 2016-12-31 | $26,473 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-12-31 | No |
| Value of net income/loss | 2016-12-31 | $-140,587 |
| Value of net assets at end of year (total assets less liabilities) | 2016-12-31 | $1,834,029 |
| Value of net assets at beginning of year (total assets less liabilities) | 2016-12-31 | $1,974,616 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2016-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2016-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2016-12-31 | No |
| Investment advisory and management fees | 2016-12-31 | $12,387 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2016-12-31 | $424,803 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2016-12-31 | $488,322 |
| Income. Interest from US Government securities | 2016-12-31 | $7,729 |
| Income. Interest from corporate debt instruments | 2016-12-31 | $7,391 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2016-12-31 | $34,104 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2016-12-31 | $29,876 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2016-12-31 | $29,876 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2016-12-31 | $103 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2016-12-31 | $205,783 |
| Asset value of US Government securities at end of year | 2016-12-31 | $432,854 |
| Asset value of US Government securities at beginning of year | 2016-12-31 | $433,207 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2016-12-31 | $11,473 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2016-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2016-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2016-12-31 | No |
| Contributions received in cash from employer | 2016-12-31 | $326,897 |
| Employer contributions (assets) at end of year | 2016-12-31 | $15,163 |
| Employer contributions (assets) at beginning of year | 2016-12-31 | $13,881 |
| Income. Dividends from common stock | 2016-12-31 | $8,929 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2016-12-31 | $113,080 |
| Asset. Corporate debt instrument debt (other) at end of year | 2016-12-31 | $227,239 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2016-12-31 | $365,303 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2016-12-31 | $692,999 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2016-12-31 | $635,315 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2016-12-31 | $0 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2016-12-31 | $522 |
| Did the plan have assets held for investment | 2016-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2016-12-31 | No |
| Aggregate proceeds on sale of assets | 2016-12-31 | $644,788 |
| Aggregate carrying amount (costs) on sale of assets | 2016-12-31 | $519,732 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2016-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2016-12-31 | Unqualified |
| Accountancy firm name | 2016-12-31 | BONADIO & CO., LLP |
| Accountancy firm EIN | 2016-12-31 | 161131146 |
| 2015 : SEIU LOCAL 200UNITED BENEFIT FUND 2015 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2015-12-31 | $-82,801 |
| Total unrealized appreciation/depreciation of assets | 2015-12-31 | $-82,801 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-12-31 | $23,515 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2015-12-31 | $25,045 |
| Total income from all sources (including contributions) | 2015-12-31 | $294,781 |
| Total loss/gain on sale of assets | 2015-12-31 | $35,916 |
| Total of all expenses incurred | 2015-12-31 | $517,873 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2015-12-31 | $278,510 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2015-12-31 | $314,239 |
| Value of total assets at end of year | 2015-12-31 | $1,998,131 |
| Value of total assets at beginning of year | 2015-12-31 | $2,222,753 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2015-12-31 | $239,363 |
| Total interest from all sources | 2015-12-31 | $26,208 |
| Total dividends received (eg from common stock, registered investment company shares) | 2015-12-31 | $16,122 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2015-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2015-12-31 | $6,975 |
| Administrative expenses professional fees incurred | 2015-12-31 | $106,926 |
| Was this plan covered by a fidelity bond | 2015-12-31 | Yes |
| Value of fidelity bond cover | 2015-12-31 | $300,000 |
| If this is an individual account plan, was there a blackout period | 2015-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2015-12-31 | No |
| Contributions received from participants | 2015-12-31 | $14,834 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2015-12-31 | $5,232 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2015-12-31 | $15,875 |
| Administrative expenses (other) incurred | 2015-12-31 | $118,685 |
| Liabilities. Value of operating payables at end of year | 2015-12-31 | $23,515 |
| Liabilities. Value of operating payables at beginning of year | 2015-12-31 | $25,045 |
| Total non interest bearing cash at end of year | 2015-12-31 | $26,473 |
| Total non interest bearing cash at beginning of year | 2015-12-31 | $35,548 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-12-31 | No |
| Value of net income/loss | 2015-12-31 | $-223,092 |
| Value of net assets at end of year (total assets less liabilities) | 2015-12-31 | $1,974,616 |
| Value of net assets at beginning of year (total assets less liabilities) | 2015-12-31 | $2,197,708 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2015-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2015-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2015-12-31 | No |
| Investment advisory and management fees | 2015-12-31 | $13,752 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2015-12-31 | $488,322 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2015-12-31 | $519,609 |
| Income. Interest from US Government securities | 2015-12-31 | $8,576 |
| Income. Interest from corporate debt instruments | 2015-12-31 | $17,602 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2015-12-31 | $29,876 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2015-12-31 | $39,459 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2015-12-31 | $39,459 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2015-12-31 | $30 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2015-12-31 | $231,586 |
| Asset value of US Government securities at end of year | 2015-12-31 | $433,207 |
| Asset value of US Government securities at beginning of year | 2015-12-31 | $335,570 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2015-12-31 | $-14,903 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2015-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2015-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2015-12-31 | No |
| Contributions received in cash from employer | 2015-12-31 | $299,405 |
| Employer contributions (assets) at end of year | 2015-12-31 | $13,881 |
| Employer contributions (assets) at beginning of year | 2015-12-31 | $28,449 |
| Income. Dividends from common stock | 2015-12-31 | $9,147 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2015-12-31 | $46,924 |
| Asset. Corporate debt instrument debt (other) at end of year | 2015-12-31 | $365,303 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2015-12-31 | $474,049 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2015-12-31 | $635,315 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2015-12-31 | $771,778 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2015-12-31 | $522 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2015-12-31 | $2,416 |
| Did the plan have assets held for investment | 2015-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2015-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2015-12-31 | No |
| Aggregate proceeds on sale of assets | 2015-12-31 | $695,781 |
| Aggregate carrying amount (costs) on sale of assets | 2015-12-31 | $659,865 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2015-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2015-12-31 | Unqualified |
| Accountancy firm name | 2015-12-31 | BONADIO & CO., LLP |
| Accountancy firm EIN | 2015-12-31 | 161131146 |
| 2014 : SEIU LOCAL 200UNITED BENEFIT FUND 2014 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2014-12-31 | $-169,132 |
| Total unrealized appreciation/depreciation of assets | 2014-12-31 | $-169,132 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-12-31 | $25,045 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2014-12-31 | $22,741 |
| Total income from all sources (including contributions) | 2014-12-31 | $528,049 |
| Total loss/gain on sale of assets | 2014-12-31 | $223,543 |
| Total of all expenses incurred | 2014-12-31 | $673,714 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2014-12-31 | $412,507 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2014-12-31 | $405,991 |
| Value of total assets at end of year | 2014-12-31 | $2,222,753 |
| Value of total assets at beginning of year | 2014-12-31 | $2,366,114 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2014-12-31 | $261,207 |
| Total interest from all sources | 2014-12-31 | $28,478 |
| Total dividends received (eg from common stock, registered investment company shares) | 2014-12-31 | $21,898 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2014-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2014-12-31 | $11,013 |
| Administrative expenses professional fees incurred | 2014-12-31 | $142,370 |
| Was this plan covered by a fidelity bond | 2014-12-31 | Yes |
| Value of fidelity bond cover | 2014-12-31 | $300,000 |
| If this is an individual account plan, was there a blackout period | 2014-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2014-12-31 | No |
| Contributions received from participants | 2014-12-31 | $10,453 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2014-12-31 | $15,875 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2014-12-31 | $69,595 |
| Administrative expenses (other) incurred | 2014-12-31 | $104,105 |
| Liabilities. Value of operating payables at end of year | 2014-12-31 | $25,045 |
| Liabilities. Value of operating payables at beginning of year | 2014-12-31 | $22,741 |
| Total non interest bearing cash at end of year | 2014-12-31 | $35,548 |
| Total non interest bearing cash at beginning of year | 2014-12-31 | $81,282 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-12-31 | No |
| Value of net income/loss | 2014-12-31 | $-145,665 |
| Value of net assets at end of year (total assets less liabilities) | 2014-12-31 | $2,197,708 |
| Value of net assets at beginning of year (total assets less liabilities) | 2014-12-31 | $2,343,373 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2014-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2014-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2014-12-31 | No |
| Investment advisory and management fees | 2014-12-31 | $14,732 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2014-12-31 | $519,609 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2014-12-31 | $534,109 |
| Income. Interest from US Government securities | 2014-12-31 | $8,309 |
| Income. Interest from corporate debt instruments | 2014-12-31 | $20,169 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2014-12-31 | $39,459 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2014-12-31 | $53,201 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2014-12-31 | $53,201 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2014-12-31 | $350,823 |
| Asset value of US Government securities at end of year | 2014-12-31 | $335,570 |
| Asset value of US Government securities at beginning of year | 2014-12-31 | $239,530 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2014-12-31 | $17,271 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2014-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2014-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2014-12-31 | No |
| Contributions received in cash from employer | 2014-12-31 | $395,538 |
| Employer contributions (assets) at end of year | 2014-12-31 | $28,449 |
| Employer contributions (assets) at beginning of year | 2014-12-31 | $27,788 |
| Income. Dividends from common stock | 2014-12-31 | $10,885 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2014-12-31 | $61,684 |
| Asset. Corporate debt instrument debt (other) at end of year | 2014-12-31 | $474,049 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2014-12-31 | $528,115 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2014-12-31 | $771,778 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2014-12-31 | $828,184 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2014-12-31 | $2,416 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2014-12-31 | $4,310 |
| Did the plan have assets held for investment | 2014-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2014-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2014-12-31 | No |
| Aggregate proceeds on sale of assets | 2014-12-31 | $699,141 |
| Aggregate carrying amount (costs) on sale of assets | 2014-12-31 | $475,598 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2014-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2014-12-31 | Unqualified |
| Accountancy firm name | 2014-12-31 | BONADIO & CO., LLP |
| Accountancy firm EIN | 2014-12-31 | 161131146 |
| 2013 : SEIU LOCAL 200UNITED BENEFIT FUND 2013 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2013-12-31 | $87,749 |
| Total unrealized appreciation/depreciation of assets | 2013-12-31 | $87,749 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-12-31 | $22,741 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2013-12-31 | $28,794 |
| Total income from all sources (including contributions) | 2013-12-31 | $788,884 |
| Total loss/gain on sale of assets | 2013-12-31 | $79,263 |
| Total of all expenses incurred | 2013-12-31 | $732,440 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2013-12-31 | $490,109 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2013-12-31 | $531,427 |
| Value of total assets at end of year | 2013-12-31 | $2,366,114 |
| Value of total assets at beginning of year | 2013-12-31 | $2,315,723 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2013-12-31 | $242,331 |
| Total interest from all sources | 2013-12-31 | $31,478 |
| Total dividends received (eg from common stock, registered investment company shares) | 2013-12-31 | $19,223 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2013-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2013-12-31 | $10,110 |
| Administrative expenses professional fees incurred | 2013-12-31 | $135,588 |
| Was this plan covered by a fidelity bond | 2013-12-31 | Yes |
| Value of fidelity bond cover | 2013-12-31 | $300,000 |
| If this is an individual account plan, was there a blackout period | 2013-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2013-12-31 | No |
| Contributions received from participants | 2013-12-31 | $11,356 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2013-12-31 | $69,595 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2013-12-31 | $63,858 |
| Administrative expenses (other) incurred | 2013-12-31 | $92,540 |
| Liabilities. Value of operating payables at end of year | 2013-12-31 | $22,741 |
| Liabilities. Value of operating payables at beginning of year | 2013-12-31 | $28,794 |
| Total non interest bearing cash at end of year | 2013-12-31 | $81,282 |
| Total non interest bearing cash at beginning of year | 2013-12-31 | $76,458 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-12-31 | No |
| Value of net income/loss | 2013-12-31 | $56,444 |
| Value of net assets at end of year (total assets less liabilities) | 2013-12-31 | $2,343,373 |
| Value of net assets at beginning of year (total assets less liabilities) | 2013-12-31 | $2,286,929 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2013-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2013-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2013-12-31 | No |
| Investment advisory and management fees | 2013-12-31 | $14,203 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2013-12-31 | $534,109 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2013-12-31 | $550,435 |
| Income. Interest from US Government securities | 2013-12-31 | $11,811 |
| Income. Interest from corporate debt instruments | 2013-12-31 | $19,667 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2013-12-31 | $53,201 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2013-12-31 | $83,404 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2013-12-31 | $83,404 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2013-12-31 | $357,959 |
| Asset value of US Government securities at end of year | 2013-12-31 | $239,530 |
| Asset value of US Government securities at beginning of year | 2013-12-31 | $431,756 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2013-12-31 | $39,744 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2013-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2013-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2013-12-31 | No |
| Contributions received in cash from employer | 2013-12-31 | $520,071 |
| Employer contributions (assets) at end of year | 2013-12-31 | $27,788 |
| Employer contributions (assets) at beginning of year | 2013-12-31 | $28,104 |
| Income. Dividends from common stock | 2013-12-31 | $9,113 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2013-12-31 | $132,150 |
| Asset. Corporate debt instrument debt (other) at end of year | 2013-12-31 | $528,115 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2013-12-31 | $419,687 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2013-12-31 | $828,184 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2013-12-31 | $657,278 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2013-12-31 | $4,310 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2013-12-31 | $4,743 |
| Did the plan have assets held for investment | 2013-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2013-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2013-12-31 | No |
| Aggregate proceeds on sale of assets | 2013-12-31 | $914,851 |
| Aggregate carrying amount (costs) on sale of assets | 2013-12-31 | $835,588 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2013-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2013-12-31 | Unqualified |
| Accountancy firm name | 2013-12-31 | BONADIO & CO., LLP |
| Accountancy firm EIN | 2013-12-31 | 161131146 |
| 2012 : SEIU LOCAL 200UNITED BENEFIT FUND 2012 401k financial data |
|---|
| Unrealized appreciation/depreciation of other (non real estate) assets | 2012-12-31 | $62,961 |
| Total unrealized appreciation/depreciation of assets | 2012-12-31 | $62,961 |
| Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-12-31 | $28,794 |
| Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2012-12-31 | $31,874 |
| Total income from all sources (including contributions) | 2012-12-31 | $832,380 |
| Total loss/gain on sale of assets | 2012-12-31 | $29,681 |
| Total of all expenses incurred | 2012-12-31 | $762,038 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2012-12-31 | $583,998 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2012-12-31 | $639,280 |
| Value of total assets at end of year | 2012-12-31 | $2,315,723 |
| Value of total assets at beginning of year | 2012-12-31 | $2,248,461 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2012-12-31 | $178,040 |
| Total interest from all sources | 2012-12-31 | $35,126 |
| Total dividends received (eg from common stock, registered investment company shares) | 2012-12-31 | $6,882 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2012-12-31 | No |
| Total dividends received from registered investment company shares (eg mutual funds) | 2012-12-31 | $1,031 |
| Administrative expenses professional fees incurred | 2012-12-31 | $66,772 |
| Was this plan covered by a fidelity bond | 2012-12-31 | Yes |
| Value of fidelity bond cover | 2012-12-31 | $300,000 |
| If this is an individual account plan, was there a blackout period | 2012-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2012-12-31 | No |
| Contributions received from participants | 2012-12-31 | $14,774 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2012-12-31 | $63,858 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2012-12-31 | $17,550 |
| Administrative expenses (other) incurred | 2012-12-31 | $97,015 |
| Liabilities. Value of operating payables at end of year | 2012-12-31 | $28,794 |
| Liabilities. Value of operating payables at beginning of year | 2012-12-31 | $31,874 |
| Total non interest bearing cash at end of year | 2012-12-31 | $76,458 |
| Total non interest bearing cash at beginning of year | 2012-12-31 | $78,389 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-12-31 | No |
| Value of net income/loss | 2012-12-31 | $70,342 |
| Value of net assets at end of year (total assets less liabilities) | 2012-12-31 | $2,286,929 |
| Value of net assets at beginning of year (total assets less liabilities) | 2012-12-31 | $2,216,587 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2012-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2012-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2012-12-31 | No |
| Investment advisory and management fees | 2012-12-31 | $14,253 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2012-12-31 | $550,435 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2012-12-31 | $373,524 |
| Interest earned on other investments | 2012-12-31 | $9,627 |
| Income. Interest from US Government securities | 2012-12-31 | $2,600 |
| Income. Interest from corporate debt instruments | 2012-12-31 | $22,875 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2012-12-31 | $83,404 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2012-12-31 | $126,014 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2012-12-31 | $126,014 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2012-12-31 | $24 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2012-12-31 | $459,335 |
| Asset value of US Government securities at end of year | 2012-12-31 | $431,756 |
| Asset value of US Government securities at beginning of year | 2012-12-31 | $792,787 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2012-12-31 | $58,450 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2012-12-31 | Yes |
| Was there a failure to transmit to the plan any participant contributions | 2012-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2012-12-31 | No |
| Contributions received in cash from employer | 2012-12-31 | $624,506 |
| Employer contributions (assets) at end of year | 2012-12-31 | $28,104 |
| Employer contributions (assets) at beginning of year | 2012-12-31 | $33,182 |
| Income. Dividends from common stock | 2012-12-31 | $5,851 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2012-12-31 | $124,663 |
| Asset. Corporate debt instrument debt (other) at end of year | 2012-12-31 | $419,687 |
| Asset. Corporate debt instrument debt (other) at beginning of year | 2012-12-31 | $452,206 |
| Assets. Corporate common stocks other than exployer securities at end of year | 2012-12-31 | $657,278 |
| Assets. Corporate common stocks other than exployer securities at beginning of year | 2012-12-31 | $374,203 |
| Assets. Value of buildings and other operty used in plan operation at end of year | 2012-12-31 | $4,743 |
| Assets. Value of buildings and other operty used in plan operation at beginning of year | 2012-12-31 | $606 |
| Did the plan have assets held for investment | 2012-12-31 | Yes |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2012-12-31 | No |
| Aggregate proceeds on sale of assets | 2012-12-31 | $844,041 |
| Aggregate carrying amount (costs) on sale of assets | 2012-12-31 | $814,360 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2012-12-31 | No |
| Opinion of an independent qualified public accountant for this plan | 2012-12-31 | Unqualified |
| Accountancy firm name | 2012-12-31 | BONADIO & CO., LLP |
| Accountancy firm EIN | 2012-12-31 | 161131146 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 365358G |
| Policy instance | 8 |
| Insurance contract or identification number | 365358G | | Number of Individuals Covered | 13 | | Insurance policy start date | 2022-02-01 | | Insurance policy end date | 2023-01-31 | | Total amount of commissions paid to insurance broker | USD $124 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $1,035 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $124 | | Insurance broker organization code? | 8 |
|
| INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 ) |
| Policy contract number | 32550 |
| Policy instance | 1 |
| Insurance contract or identification number | 32550 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $36,914 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00310713 |
| Policy instance | 2 |
| Insurance contract or identification number | 00310713 | | Number of Individuals Covered | 15 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | POS | | Welfare Benefit Premiums Paid to Carrier | USD $88,734 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 1 |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00316629 |
| Policy instance | 3 |
| Insurance contract or identification number | 00316629 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $685 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | POS | | Welfare Benefit Premiums Paid to Carrier | USD $18,274 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $685 | | Insurance broker organization code? | 3 |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00403894 |
| Policy instance | 4 |
| Insurance contract or identification number | 00403894 | | Number of Individuals Covered | 6 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $1,903 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | POS | | Welfare Benefit Premiums Paid to Carrier | USD $59,106 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,903 | | Insurance broker organization code? | 9 |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3216280 |
| Policy instance | 5 |
| Insurance contract or identification number | 3216280 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,832 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00513758 |
| Policy instance | 6 |
| Insurance contract or identification number | 00513758 | | Number of Individuals Covered | 705 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $3,779 | | Total amount of fees paid to insurance company | USD $448 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $39,781 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,779 | | Amount paid for insurance broker fees | 448 | | Insurance broker organization code? | 2 |
|
| HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | Y2K |
| Policy instance | 7 |
| Insurance contract or identification number | Y2K | | Number of Individuals Covered | 381 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $2,216 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $22,165 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,216 | | Insurance broker organization code? | 6 |
|
| INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 ) |
| Policy contract number | 32550 |
| Policy instance | 1 |
| Insurance contract or identification number | 32550 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $42,913 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00310713 |
| Policy instance | 2 |
| Insurance contract or identification number | 00310713 | | Number of Individuals Covered | 15 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | POS | | Welfare Benefit Premiums Paid to Carrier | USD $97,944 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00316629 |
| Policy instance | 3 |
| Insurance contract or identification number | 00316629 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $716 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | POS | | Welfare Benefit Premiums Paid to Carrier | USD $22,982 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $716 | | Insurance broker organization code? | 3 |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00403894 |
| Policy instance | 4 |
| Insurance contract or identification number | 00403894 | | Number of Individuals Covered | 6 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $1,635 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | POS | | Welfare Benefit Premiums Paid to Carrier | USD $43,607 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,635 | | Insurance broker organization code? | 3 |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3216280 |
| Policy instance | 5 |
| Insurance contract or identification number | 3216280 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $2,198 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00513758 |
| Policy instance | 6 |
| Insurance contract or identification number | 00513758 | | Number of Individuals Covered | 700 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $3,865 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $41,562 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,865 | | Insurance broker organization code? | 3 |
|
| HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | Y2K |
| Policy instance | 7 |
| Insurance contract or identification number | Y2K | | Number of Individuals Covered | 352 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $1,868 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $18,678 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,868 | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 365358G |
| Policy instance | 8 |
| Insurance contract or identification number | 365358G | | Number of Individuals Covered | 13 | | Insurance policy start date | 2021-02-01 | | Insurance policy end date | 2022-01-31 | | Total amount of commissions paid to insurance broker | USD $126 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $1,052 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $126 | | Insurance broker organization code? | 3 |
|
| INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 ) |
| Policy contract number | 32550 |
| Policy instance | 1 |
| Insurance contract or identification number | 32550 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $44,738 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00310713 |
| Policy instance | 2 |
| Insurance contract or identification number | 00310713 | | Number of Individuals Covered | 15 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | POS | | Welfare Benefit Premiums Paid to Carrier | USD $91,568 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00316629 |
| Policy instance | 3 |
| Insurance contract or identification number | 00316629 | | Number of Individuals Covered | 5 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $1,298 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | POS | | Welfare Benefit Premiums Paid to Carrier | USD $34,607 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $970 | | Insurance broker organization code? | 3 |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00403894 |
| Policy instance | 4 |
| Insurance contract or identification number | 00403894 | | Number of Individuals Covered | 5 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $1,381 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | POS | | Welfare Benefit Premiums Paid to Carrier | USD $36,816 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,032 | | Insurance broker organization code? | 3 |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3216280 |
| Policy instance | 5 |
| Insurance contract or identification number | 3216280 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,401 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00513758 |
| Policy instance | 6 |
| Insurance contract or identification number | 00513758 | | Number of Individuals Covered | 721 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $3,963 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $42,612 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $3,963 | | Insurance broker organization code? | 3 |
|
| HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | Y2K |
| Policy instance | 7 |
| Insurance contract or identification number | Y2K | | Number of Individuals Covered | 269 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $1,293 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $12,935 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $653 | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 365358G |
| Policy instance | 8 |
| Insurance contract or identification number | 365358G | | Number of Individuals Covered | 14 | | Insurance policy start date | 2020-02-01 | | Insurance policy end date | 2021-01-31 | | Total amount of commissions paid to insurance broker | USD $126 | | Total amount of fees paid to insurance company | USD $12 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $1,053 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $126 | | Amount paid for insurance broker fees | 12 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 ) |
| Policy contract number | 32550 |
| Policy instance | 1 |
| Insurance contract or identification number | 32550 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $48,562 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00310713 |
| Policy instance | 2 |
| Insurance contract or identification number | 00310713 | | Number of Individuals Covered | 11 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | POS | | Welfare Benefit Premiums Paid to Carrier | USD $48,948 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $0 | | Insurance broker organization code? | 3 |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00403894 |
| Policy instance | 4 |
| Insurance contract or identification number | 00403894 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $1,047 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | POS | | Welfare Benefit Premiums Paid to Carrier | USD $27,912 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,047 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00316629 |
| Policy instance | 3 |
| Insurance contract or identification number | 00316629 | | Number of Individuals Covered | 5 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $1,230 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | POS | | Welfare Benefit Premiums Paid to Carrier | USD $32,797 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,230 | | Insurance broker organization code? | 3 |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3216280 |
| Policy instance | 5 |
| Insurance contract or identification number | 3216280 | | Number of Individuals Covered | 8 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $6,482 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 ) |
| Policy contract number | 61217C/61217D |
| Policy instance | 6 |
| Insurance contract or identification number | 61217C/61217D | | Number of Individuals Covered | 16 | | Insurance policy start date | 2018-05-01 | | Insurance policy end date | 2019-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $5,116 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00513758 |
| Policy instance | 7 |
| Insurance contract or identification number | 00513758 | | Number of Individuals Covered | 640 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $2,041 | | Total amount of fees paid to insurance company | USD $1,189 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $21,943 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $2,041 | | Amount paid for insurance broker fees | 1189 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 |
|
| HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | Y2K |
| Policy instance | 8 |
| Insurance contract or identification number | Y2K | | Number of Individuals Covered | 24 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $182 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,819 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $182 | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 365358G |
| Policy instance | 9 |
| Insurance contract or identification number | 365358G | | Number of Individuals Covered | 14 | | Insurance policy start date | 2019-02-01 | | Insurance policy end date | 2020-01-31 | | Total amount of commissions paid to insurance broker | USD $126 | | Total amount of fees paid to insurance company | USD $5 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $1,053 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $126 | | Amount paid for insurance broker fees | 5 | | Additional information about fees paid to insurance broker | BONUS | | Insurance broker organization code? | 3 |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00403894 |
| Policy instance | 4 |
| Insurance contract or identification number | 00403894 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $1,171 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | POS | | Welfare Benefit Premiums Paid to Carrier | USD $30,808 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,171 | | Insurance broker organization code? | 3 |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3216280 |
| Policy instance | 5 |
| Insurance contract or identification number | 3216280 | | Number of Individuals Covered | 11 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $8,247 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 ) |
| Policy contract number | 61217C/61217D |
| Policy instance | 6 |
| Insurance contract or identification number | 61217C/61217D | | Number of Individuals Covered | 20 | | Insurance policy start date | 2017-05-01 | | Insurance policy end date | 2018-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $5,369 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00513758 |
| Policy instance | 7 |
| Insurance contract or identification number | 00513758 | | Number of Individuals Covered | 336 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $1,580 | | Total amount of fees paid to insurance company | USD $127 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $16,993 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,580 | | Amount paid for insurance broker fees | 127 | | Insurance broker organization code? | 3 |
|
| HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 ) |
| Policy contract number | Y2K |
| Policy instance | 8 |
| Insurance contract or identification number | Y2K | | Number of Individuals Covered | 37 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $168 | | Total amount of fees paid to insurance company | USD $0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $1,683 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $168 | | Insurance broker organization code? | 3 |
|
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) |
| Policy contract number | 365358G |
| Policy instance | 9 |
| Insurance contract or identification number | 365358G | | Number of Individuals Covered | 14 | | Insurance policy start date | 2018-02-01 | | Insurance policy end date | 2019-01-31 | | Total amount of commissions paid to insurance broker | USD $126 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Other welfare benefits provided | AD&D | | Welfare Benefit Premiums Paid to Carrier | USD $1,053 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $126 | | Insurance broker organization code? | 3 |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00316629 |
| Policy instance | 3 |
| Insurance contract or identification number | 00316629 | | Number of Individuals Covered | 5 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $1,240 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | POS | | Welfare Benefit Premiums Paid to Carrier | USD $32,875 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,240 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00310713 |
| Policy instance | 2 |
| Insurance contract or identification number | 00310713 | | Number of Individuals Covered | 9 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | POS | | Welfare Benefit Premiums Paid to Carrier | USD $39,092 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 ) |
| Policy contract number | 32550 |
| Policy instance | 1 |
| Insurance contract or identification number | 32550 | | Number of Individuals Covered | 5 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $50,719 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 ) |
| Policy contract number | 32550 |
| Policy instance | 1 |
| Insurance contract or identification number | 32550 | | Number of Individuals Covered | 7 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $48,846 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $0 | | Amount paid for insurance broker fees | 0 | | Insurance broker name | |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00310713 |
| Policy instance | 2 |
| Insurance contract or identification number | 00310713 | | Number of Individuals Covered | 7 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | POS | | Welfare Benefit Premiums Paid to Carrier | USD $56,173 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $0 | | Amount paid for insurance broker fees | 0 | | Insurance broker name | |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00316629 |
| Policy instance | 3 |
| Insurance contract or identification number | 00316629 | | Number of Individuals Covered | 5 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $179 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | POS | | Welfare Benefit Premiums Paid to Carrier | USD $31,016 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $179 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Insurance broker name | ENV INSURANCE AGENCY, LLC |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00403894 |
| Policy instance | 4 |
| Insurance contract or identification number | 00403894 | | Number of Individuals Covered | 5 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $185 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | POS | | Welfare Benefit Premiums Paid to Carrier | USD $31,344 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $185 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 | | Insurance broker name | ENV INSURANCE AGENCY, LLC |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3216280 |
| Policy instance | 5 |
| Insurance contract or identification number | 3216280 | | Number of Individuals Covered | 16 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $12,004 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $0 | | Amount paid for insurance broker fees | 0 | | Insurance broker name | |
|
| EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 ) |
| Policy contract number | 61217C/61217D |
| Policy instance | 6 |
| Insurance contract or identification number | 61217C/61217D | | Number of Individuals Covered | 23 | | Insurance policy start date | 2016-05-01 | | Insurance policy end date | 2017-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $5,319 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $0 | | Amount paid for insurance broker fees | 0 | | Insurance broker name | |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00513758 |
| Policy instance | 7 |
| Insurance contract or identification number | 00513758 | | Number of Individuals Covered | 235 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $635 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $11,056 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 635 | | Insurance broker organization code? | 3 | | Insurance broker name | LAWLEY BENEFITS GROUP LLC |
|
| INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 ) |
| Policy contract number | 32550 |
| Policy instance | 1 |
| Insurance contract or identification number | 32550 | | Number of Individuals Covered | 6 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $44,557 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00310713 |
| Policy instance | 2 |
| Insurance contract or identification number | 00310713 | | Number of Individuals Covered | 15 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | POS | | Welfare Benefit Premiums Paid to Carrier | USD $77,155 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00316629 |
| Policy instance | 3 |
| Insurance contract or identification number | 00316629 | | Number of Individuals Covered | 6 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Other welfare benefits provided | POS | | Welfare Benefit Premiums Paid to Carrier | USD $77,155 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3216280 |
| Policy instance | 5 |
| Insurance contract or identification number | 3216280 | | Number of Individuals Covered | 33 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $23,154 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00403894 |
| Policy instance | 4 |
| Insurance contract or identification number | 00403894 | | Number of Individuals Covered | 6 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Dental Insurance Welfare Benefit | Yes | | Other welfare benefits provided | POS | | Welfare Benefit Premiums Paid to Carrier | USD $36,823 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 ) |
| Policy contract number | P32354 |
| Policy instance | 1 |
| Insurance contract or identification number | P32354 | | Number of Individuals Covered | 0 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $21,763 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00302214 |
| Policy instance | 2 |
| Insurance contract or identification number | 00302214 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | POS | | Welfare Benefit Premiums Paid to Carrier | USD $14,427 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00316629 |
| Policy instance | 5 |
| Insurance contract or identification number | 00316629 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | POS | | Welfare Benefit Premiums Paid to Carrier | USD $23,006 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00403731 |
| Policy instance | 4 |
| Insurance contract or identification number | 00403731 | | Number of Individuals Covered | 12 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | POS | | Welfare Benefit Premiums Paid to Carrier | USD $62,737 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) |
| Policy contract number | 3216280 |
| Policy instance | 7 |
| Insurance contract or identification number | 3216280 | | Number of Individuals Covered | 40 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $25,183 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00310713 |
| Policy instance | 3 |
| Insurance contract or identification number | 00310713 | | Number of Individuals Covered | 15 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | POS | | Welfare Benefit Premiums Paid to Carrier | USD $23,006 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 ) |
| Policy contract number | 61217C103-D050 |
| Policy instance | 8 |
| Insurance contract or identification number | 61217C103-D050 | | Number of Individuals Covered | 45 | | Insurance policy start date | 2013-05-01 | | Insurance policy end date | 2014-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $23,626 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00403894 |
| Policy instance | 6 |
| Insurance contract or identification number | 00403894 | | Number of Individuals Covered | 11 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | POS | | Welfare Benefit Premiums Paid to Carrier | USD $46,705 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | 365358G |
| Policy instance | 1 |
| Insurance contract or identification number | 365358G | | Number of Individuals Covered | 42 | | Insurance policy start date | 2013-02-01 | | Insurance policy end date | 2014-01-31 | | Total amount of commissions paid to insurance broker | USD $37 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $3,122 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $37 | | Insurance broker name | BENEFIT CONSULTING GROUP, INC. |
|
| INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 ) |
| Policy contract number | 32354K |
| Policy instance | 2 |
| Insurance contract or identification number | 32354K | | Number of Individuals Covered | 7 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $40,374 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00302214 |
| Policy instance | 3 |
| Insurance contract or identification number | 00302214 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | POS | | Welfare Benefit Premiums Paid to Carrier | USD $16,957 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00310713 |
| Policy instance | 4 |
| Insurance contract or identification number | 00310713 | | Number of Individuals Covered | 15 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | POS | | Welfare Benefit Premiums Paid to Carrier | USD $91,640 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00403731 |
| Policy instance | 5 |
| Insurance contract or identification number | 00403731 | | Number of Individuals Covered | 14 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | POS | | Welfare Benefit Premiums Paid to Carrier | USD $76,932 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00316629 |
| Policy instance | 6 |
| Insurance contract or identification number | 00316629 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | POS | | Welfare Benefit Premiums Paid to Carrier | USD $33,109 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00403894 |
| Policy instance | 7 |
| Insurance contract or identification number | 00403894 | | Number of Individuals Covered | 7 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | POS | | Welfare Benefit Premiums Paid to Carrier | USD $42,928 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| THE FIRST REHABILITATION LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 81434 ) |
| Policy contract number | GVNY3302 |
| Policy instance | 8 |
| Insurance contract or identification number | GVNY3302 | | Number of Individuals Covered | 97 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $18 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $150 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Amount paid for insurance broker fees | 18 | | Insurance broker organization code? | 3 | | Insurance broker name | THE ARGIRO GROUP, INC. |
|
| EMBLEM HEALTH (National Association of Insurance Commissioners NAIC id number: 55239 ) |
| Policy contract number | 61217C103-107 |
| Policy instance | 2 |
| Insurance contract or identification number | 61217C103-107 | | Number of Individuals Covered | 51 | | Insurance policy start date | 2011-05-01 | | Insurance policy end date | 2012-04-30 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $31,444 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 ) |
| Policy contract number | 32354K |
| Policy instance | 3 |
| Insurance contract or identification number | 32354K | | Number of Individuals Covered | 7 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $40,171 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00302214 |
| Policy instance | 4 |
| Insurance contract or identification number | 00302214 | | Number of Individuals Covered | 2 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | POS | | Welfare Benefit Premiums Paid to Carrier | USD $16,187 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00310713 |
| Policy instance | 5 |
| Insurance contract or identification number | 00310713 | | Number of Individuals Covered | 12 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | POS | | Welfare Benefit Premiums Paid to Carrier | USD $46,733 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00312777 |
| Policy instance | 6 |
| Insurance contract or identification number | 00312777 | | Number of Individuals Covered | 1 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | POS | | Welfare Benefit Premiums Paid to Carrier | USD $6,831 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00312124 |
| Policy instance | 7 |
| Insurance contract or identification number | 00312124 | | Number of Individuals Covered | 10 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | POS | | Welfare Benefit Premiums Paid to Carrier | USD $27,958 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00403731 |
| Policy instance | 8 |
| Insurance contract or identification number | 00403731 | | Number of Individuals Covered | 14 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | POS | | Welfare Benefit Premiums Paid to Carrier | USD $71,105 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00316629 |
| Policy instance | 9 |
| Insurance contract or identification number | 00316629 | | Number of Individuals Covered | 7 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | POS | | Welfare Benefit Premiums Paid to Carrier | USD $46,733 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 ) |
| Policy contract number | 365358G |
| Policy instance | 1 |
| Insurance contract or identification number | 365358G | | Number of Individuals Covered | 42 | | Insurance policy start date | 2012-02-01 | | Insurance policy end date | 2013-01-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Life Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $4,130 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: ) |
| Policy contract number | 00403894 |
| Policy instance | 10 |
| Insurance contract or identification number | 00403894 | | Number of Individuals Covered | 10 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Total amount of commissions paid to insurance broker | USD $0 | | Total amount of fees paid to insurance company | USD $0 | | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | | Contracts With Unallocated Funds Deposit Administration | 0 | | Other welfare benefits provided | POS | | Welfare Benefit Premiums Paid to Carrier | USD $52,478 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
